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The 2008 physical activity guidelines for Americans just attention to the growing problem of

Physical inactivity among adults, & the little progress that has been made to reverse the trend.

As little as 2.5 hours a week of Moderate aerobic physical activity can substantially reduce

Chances for chronic diseases, leading to significant health benefits.

What is one of the most important goals of the 2008 physical activity guidelines for Americans? What percentage of US adults engage in regular leisure time physical activity

Small doses of regular physical activity can help prevent, treat, & cure more than 40 of the most common chronic health conditions.

What percentage of US adults engage in regular leisure time physical activity?

30%

(3x/week of vigorous 20+ min workouts or 5x/week of light-to-moderate 30+ min workouts)

A comprehensive fitness assessment

A series of measurements that help to determine the current health/fitness level of clients.

Health & fitness assessments are not designed to

Diagnose medical/health conditions.

Instead health & fitness assessments are designed to

Serve as a way of observing/documenting a clients individual structural & functional status.

Health & fitness professionals do not

Diagnose medical conditions


Prescribe treatment or diets


Provide treatment of any kind for injury/disease


Provide rehabilitation services for clients.


Provide counseling services for clients

There are 5

A comprehensive fitness assessment provides a variety of

Subjective & objective information, a pre-participation health screening, resting physiological measurements (HR, BP, ht, & wt) , & hey series of measurements to help determine their fitness level.

Fitness assessment subjective information

General & medical history :


Lifestyle, occupation, medical & personal info

Fitness assessment objective information

Physiological assess


Body composition testing


Cardiorespiratory assess


Static & dynamic posture assess


Performance assess

There are 5

Subjective information is gathered from a prospective client to give

the health & fitness professional feedback regarding personal history.

A pre-participation health screening includes a

Medical history questionnaire (PAR-Q), a review of their chronic disease risk factors, & presence of any signs/symptoms of disease.

What are the 3 classifications after a pre-participation health screening has taking place?

Low risk


Moderate risk


High risk

Those who are considered low risk after the Pre-participation health screening

Don’t have any signs/symptoms of cardiovascular, pulmonary, or metabolic disease & have = 1 cardiovascular disease risk factor.

Those who are considered moderate risk after the Pre-participation health screening

Don’t have any signs/symptoms of cardiovascular, pulmonary, or metabolic disease but have >/= 2 cardiovascular disease risk factors.

Those who are considered high risk after the Pre-participation health screening

Have 1 or more signs/symptoms of cardiovascular, pulmonary, or metabolic disease.

After the pre-participation health screening information has been collected/reviewed/stratified

Personal trainers can now to proceed with fitness testing/refer the client for further medical evaluation.

Physical activity readiness questionnaire (PAR-Q)

Determines the safety/possible risk of exercising for a client based on answers to specific health questions.

Usually for individuals who require further medical evaluation (high risk) before they’re allowed to exercise.

Answering yes to one or more questions on the PAR-Q, The personal trainers should

Refer them to a physician for further medical screening before starting an exercise program.

PAR-Q sample question

In the past month, have you had chest pain when you were not performing any physical activity?

A health history is a collection of information that is generally part of a medical physical/ medical health history, including

Biographic, demographic, occupational, general lifestyle (physical, mental, emotional, sociocultural, sexual, spiritual)

Occupation


General

Occupation


General

A client’s occupation information helps personal trainer determine

Common movement patterns & typical energy expenditure levels during the course of an average day.

Once occupational information is collected trainers can begin to recognize important clues about the client’s

Muscular skeletal structure/function, potential health/physical limitations, & restrictions that could affect safety & efficacy of the program.

Examples of occupation questions : Does your occupation require/causeSitting for long periods of time can lead to...

Extended periods of sitting?


Extended periods of repetitive movements?


Shoes with heels?


You anxiety (mental stress)?

Sitting for long periods of time can lead to

Tight hip flexors (rectus femoris, tensor fascia latae, iliopsoas)


Postural and balances in the HMS

Sitting for long periods of time over a computer leads to

Shoulders and head to fatigue leading to postural imbalances.

Rounded shoulders


Forward head

Low energy expenditure and potentially poor cardiorespiratory conditioning can be assumed when individuals

Sit for prolonged periods of time.

Repetitive movement is a

Persistent motion that can cause musculoskeletal injury & dysfunction.

What can create a pattern overload to muscles & Working with arms overhead for long periods may lead tojoints, which may lead to tissue trauma & eventually kinetic chain dysfunction?

Repetitive movements

Working with the arms OH For long periods may lead to

Shoulder and neck soreness.


This may be the result of : tightness in the latissimus dorsi & weakness in the rotator cuff.

Working OH does not allow for

Proper shoulder motion/stabilization during activity

Wearing dress shoes with a puts the ankle complex in a

A plantarflexed position for extended periods.

Wearing heels for an extended time can cause tightness in the

Gastrocnemius


Soleus


Achilles tendon

Wearing heels can cause posture imbalances such as

Decreased dorsiflexion


Overpronation at the foot and ankle complex

This can result in flattening the arch of the foot.

Mental stress or anxiety can cause elevated

Resting heart rate


Blood pressure


Ventilation at rest & exercise

Mental stress can lead to abnormal or dysfunctional

Breathing patterns.

These abnormal breathing patterns caused by mental stress may cause

postural or muscular skeletal muscle imbalances in the neck, shoulder, chest, and low back muscles.

May lead to postural distortion & HMS dysfunction.

Lifestyle or personal questions pertains to a clients general lifestyle activities & habits such as...

Drinking, smoking, exercise, & sleeping habits as well as recreational activities & hobbies.

Sample questions : client’s lifestyle

Do you partake in any recreational activities (golf, tennis, skiing)?


Do you have any hobbies (reading, gardening, working on cars)?

Recreation refers to a client’s

Physical activities outside of the work environment (leisure time).

Many clients like to golf, ski, play tennis, or perform a variety of other sporting activities in their spare time, proper exercise training must be

Incorporated to ensure that clients are trained in a matter that optimizes the efficiency of the HMS, without predisposing it to injury.

Hobbies refer to

Activities that a client might enjoy participating in on a regular basis.

Gardening, working on cars, playing cards, reading, watching television, playing video games.

Medical history is important because it

Provides us with info about known/suspected chronic diseases, past/current injuries, health status, or surgeries.

Coronary heart disease, high blood pressure, diabetes.

All past or recent injuries should be recorded and discussed in sufficient enough detail to be able to

Make decisions about whether exercise is recommended or a medical referral is necessary.

Previous history of musculoskeletal injury is also a strong predictor of

Future musculoskeletal injury during physical activity.

Surgery will cause pain and inflammation that can alterMore than 75% of the American adult population is estimated tonight

Neural control to the affected muscles/joints if not rehabilitated properly.

More than 75% of the American adult population is estimated to not engage in

At least 30 minutes of low-to-moderate physical activity on most days of the week.

Chronic diseases include :

CVD


Coronary heart/artery disease


Congestive heart failure


Hypertension (high BP)


High cholesterol/other blood lipid disorders


Stroke/peripheral artery disease


Lungs/breathing problems


Obesity


Diabetes mellitus


Cancer

Many seeking fitness exercise training advise from personal trainers will currently be under the care of

A physician/medical professional & maybe taking one or more prescribed medications.

What is a PDR?

Physician’s desk reference

Beta blockers (B-blockers)

Anti-hypertensive (high BP), prescribed for arrhythmias (irregular HR).

Calcium-channel blockers

Prescribed for hypertension & angina (chest pain)

Ankle sprains have been shown to decrease the

Neural control to the gluteus medius/maximus muscles, leading support control of the lower extremities during functional activities.

Knee injuries can cause a decrease in the number control to the muscles that

Stabilize the patella and lead to further injury.

Noncontact Knee injuries Are often the resultIf the ankle hip begins to function properly, this results in of

Ankle/hip dysfunctions, such as the result of an ankle sprain.

If the ankle/hip begins to function improperly, this results in

Altered movement & force distribution of the knee.

Low back injuries can cause decreased neural control to stabilizing muscles of the

Core, resulting in poor stabilization of the spine, leading to dysfunction in the upper/lower extremities.

Shoulder injuries cause altered neural control of the

Rotator cuff muscles, leading to instability of the shoulder joint during functional activities.

Entries that result from HMS and balances include repetitive

Hamstring strain & groin strain, patella tendinitis (jumpers knee), plantar fasciitis (pain in heel/bottom of foot), posterior Tibialis tendinitis (shin splints), biceps tendinitis (shoulder pain), & headaches.

There are 7

Beta blockers (B-blockers)

Anti-hypertensive (high BP), prescribed for arrhythmias (irregular HR).

Decreased HR


Decreased BP

Calcium-channel blockers

Prescribed for hypertension & angina (chest pain)

Increased/no change/decreased HR


Decreased BP

Nitrates

Hypertension, congestive heart failure.

Increased/no change HR


Increased/no change BP

Dieuretics

Hypertension, congestive heart failure, & peripheral edema.

No change in HR


Decreased/no change in BP

Broncodilators

Corrects/prevents bronchial smooth muscle constriction in individuals with asthma & other pulmonary diseases.

No change in HR


No change in BP

Vasodilators

Hypertension & congestive heart failure.

Increase/no change/decrease in HR


Decrease in BP

Antidepressants

Various psychiatric & emotional disorders.

Increase/no change in HR


Decrease/no change in BP

Objective information collected during a fitness assessment includes

Resting exercise physiological measurement (BP & heart rate), resting Anthrometric measurements (ht, et, BFP, circumference measurements), in specific measures of fitness (muscular durance, flexibility, cardiorespiratory).

Objective information collected un the fitness assessment can be used to

Compare beginning baseline measures of fitness with measurements taken weeks, months, or even years later.

Categories of objective information include

Physiological measurements


Buddy comp assess


Cardiorespiratory assess


Static posture assess


Movement assess (dynamic posture)


Performance assess

There are 6

When checking the radial pulse consider

Being gentle


Taking it when calm


Take all three test at the same time for accuracy

To find the I’m checking the carotid pulse considercarotid pulse

Look on the neck just to the side of the larynx.

When checking the carotid pulse considerThe typical resting heart rate is between

Being gentle


Excessive pressure can decrease HR/BPleading to an accurate reading, possible dizziness, & fainting.


Taken when calm

The typical resting heart rate is between

70-80 beats/min


70 bpm for males


75 bpm for females

Resting heart rate can be used to calculate

Target heart rate (THR) zones in which a client should perform cardio respiratory exercise.

What are the 2 most common ways to calculate THR?

Use a percentage of estimated maximal heart rate (straight percentage method)


Use a percentage of heart rate reserve (Karvonen method)

Straight percentage method (peak maximal heart rate) Is found by

220-Age = HR max


HR max X appropriate intensity (65-95%) at which the client should work while performing cardio respiratory exercise to calculate THR.

There are how many training zones for THR?

3

Resting HR and VP is a sensitive indicator of the client’s

Overall cardio respiratory health & fitness status.

Initial assess/reassess of a client’s HR & BP helps to gather valuable information that helps in the

Design, monitoring, & progression of the clients exercise program.

Resting HR is a fairly good indicator of overall cardiorespiratory fitness, where as exercise HR is a strong indicator of

How a client’s cardiorespiratory system is responding/adapting to exercise.

A pulse is created by

Blood moving/pulsating through arteries each time the heart contracts.

Heart rate

Heart rate

The two most common sites to record a pulse are the

Radial (wrist) & carotid (neck) arteries.


Use the carotid with caution

The best time to record an accurate resting heart rate is

Rising in the morning.

The radio pulse can be found

Along the right side of the arm in the line just above the thumb.

When the pulse is felt count it for

60 seconds

Record the 60 second pulse rate average over the course of 3 days

Target heart rate training zone 1 builds

Aerobic base & aids in recovery.


HR max X .65


HR max X .75

Target heart rate training zone 2 increases

Aerobic & anaerobic endurance.


HR max X .76


HR max X .85

Target heart rate training zone 3 builds

High end work capacity


HR max .86


HR max .95

Exercise intensity levels may need to be lower than

66% depending on the clients initial physical condition. (40-55%)

Heart rate reserve (HRR) method (Karvonen method) Establishes The most common and university accepted method of establishing exercise training intensity is

Training intensity on the basis of the difference between the clients predicted HR max & they’re resting heart rate.

The most common and university accepted method of establishing exercise training intensity is

Selecting a predetermined training/THR based on a given percentage of oxygen consumption.

Blood pressure

The pressure of the circulating blood against the walls of the blood vessels after the blood is ejected from the heart.

There are two parts to a blood pressure measurement what are they?

Systolic (the top number)


diastolic (the bottom number)

Systolic represents the pressure within

The arterial system after the heart contracts.

Diastolic represents the pressure within

The pressure within the arterial system of the heart is resting & filling with blood.

According to the American Heart Association (AHA) an acceptable systolic blood pressure measurement for health is

= 120 mm Hg of mercury (Hg)


An acceptable diastolic blood pressure is

= 80mm Hg

Fat free mass can be defined as

Body weight except stored fat, this includes muscles, bones, water, connective/organ tissues, teeth.

Fat mass includes

Both essential fat (crucial for normal body functioning) & non-essential fat (storage fat/adipose tissue).

Benefits of body composition assessment include

Identifying clients health risk for excessive high/low levels of body fat.


Promotes clients understanding.


monitoring changes in body comp itself/associated with chronic disease.


Helps estimate health bodyweight.


Assists in exercise program design.


Use as a motivational tool.


Assess his effectiveness of nutrition/exercise choices.

There are 7

Body fat typically ranges from ___ to ___ for men?

10-20%

Body fat typically ranges from ___ to ___ for women?

20-30%

Body fat recommendations for men and women are

15% men


25% women

Skinfold measurements

Uses a caliper to estimate the amount of subcutaneous fat beneath the skin.

Percent fat recommendations for men and women pictured

Back (Definition)

Blood pressure is measured using an

Aneroid sphygmomanometer, and inflatable cuff, a pressure dial, a bulb with a valve, & a stethoscope.

When recording blood pressure instruct the client to

Get in a comfortable see the position placing the appropriate size cuff on the clients arm just above the elbow.

Have the client rest the alarm on

A supported chair/own arm, placing the stethoscope over the brachial artery using minimal pressure.

Rapidly inflate the cuff to

20-30 mm Hg above the point at which the pulse can no longer be felt at the wrist.

Release the pressure of the sphygmomanometer at a rate of about

2 mm Hg/sec listening for a pulse

To determine the systolic pressure listen for

The first observation of the pulse.

Diastolic pressure is determined when

The pulse fades away.

For greater reliability on the blood pressure assessment

Repeat the procedure on the opposite arm.

The relative percentage of body weight.


Fat vs fat free tissue = Percent body fat

The relative percentage of body weight.


Fat vs fat free tissue = Percent body fat

An acceptable diastolic blood pressure is

= 80mm Hg

Fat free mass can be defined as

Body weight except stored fat, this includes muscles, bones, water, connective/organ tissues, teeth.

Fat mass includes

Both essential fat (crucial for normal body functioning) & non-essential fat (storage fat/adipose tissue).

Benefits of body composition assessment include

Identifying clients health risk for excessive high/low levels of body fat.


Promotes clients understanding.


monitoring changes in body comp itself/associated with chronic disease.


Helps estimate health bodyweight.


Assists in exercise program design.


Use as a motivational tool.


Assess his effectiveness of nutrition/exercise choices.

There are 7

Body fat typically ranges from ___ to ___ for men?

10-20%

Body fat typically ranges from ___ to ___ for women?

20-30%

Body fat recommendations for men and women are

15% men


25% women

Skinfold measurements

Uses a caliper to estimate the amount of subcutaneous fat beneath the skin.

Percent fat recommendations for men and women pictured

Back (Definition)

Blood pressure is measured using an

Aneroid sphygmomanometer, and inflatable cuff, a pressure dial, a bulb with a valve, & a stethoscope.

When recording blood pressure instruct the client to

Get in a comfortable see the position placing the appropriate size cuff on the clients arm just above the elbow.

Have the client rest the alarm on

A supported chair/own arm, placing the stethoscope over the brachial artery using minimal pressure.

Rapidly inflate the cuff to

20-30 mm Hg above the point at which the pulse can no longer be felt at the wrist.

Release the pressure of the sphygmomanometer at a rate of about

2 mm Hg/sec listening for a pulse

To determine the systolic pressure listen for

The first observation of the pulse.

Diastolic pressure is determined when

The pulse fades away.

For greater reliability on the blood pressure assessment

Repeat the procedure on the opposite arm.

Percent fat recommendations for men and women pictured

Back (Definition)

Percent fat recommendations for active men & women

Back (Definition)

Bioelectrical impedance

Uses a portable instrument to conduct an electrical current through the body to estimate fat.

Bioelectric impedance is based on

Hypothesis that tissues that are high in water content conduct electrical currents with less resistance than those with Little water (adipose tissue).

Underwater weighing (Hydrostatic weighing) is the

Most common technique used for body comp.

Bone, muscle, connective tissue (lean mass) do what during hydrostatic weighing

Sink.

Body fat does what during hydrostatic weighing?

Float.

Bone, muscle, connective tissue (lean mass) do what during hydrostatic weighing?

Sink.

A person with a larger percentage of lean body mass will weigh

More in the water, ultimately having a lower body fat percentage.

Formula on how to calculate ones fat mass & lean body mass :

Body fat % X scale wt = fat mass


Scale wt - fat mass = lean mass

Calculate the fat mass in lean body mass of a 40-year-old woman weighing 130 lbs

Fat Mass :


.28 (bf%) X 130 (swt) =


36lbs of BF



Lean Body Mass :


130(swt) - 36(lbs of wt) =


94lbs of LBM

A circumference measurement is a measure of the

Girth of body segments (arm, thigh, waist, & hip)

Circumference methods are affected by both

Fat & muscle, therefore I do not provide accurate estimates of fatness.

Some of the uses & benefits of circumference measurements include :

Can be used on obese clients.


Good for comparisons/progressions.


Good for assessing fat pattern & distribution.


Inexpensive.


Little technician error.


Easy to record.


used for waist concert conference.


Used for waist to hip ratio (WHR).

The most important factor to consider when taking circumference measurements is

Consistency, make sure that the tape is taut & level around the area being measured.

A person with more body fat will have a

Lighter body of water & higher percentage of body fat.

Skinfolds (SKF) tests has the assumption that the amount of fat present in the subcutaneous regions of the body is

Proportional to overall body fitness.

Recommendations for assessing body copies in skin folds is :In a SM uses the

Train with those skilled in SKF & frequently compare results.


Take a minimum of 2 measurements at each site, each site must be within 1-2 mm to take average at each site.


Open jaw of caliper before removing from site.


Be meticulous when locating anatomic landmarks.


Don’t measure SKF immediately after exercise.


Instruct clients ahead of time regarding test protocol.


Avoid performing SKFs on extremely obese clients.

In a SM uses the Durnin (Durnin-Womersley) formula To calculate a client’s

Percentage of body fat.

Durban formula’s 4 sites of skinfold measurements are as follows :

Biceps


Triceps


Subscapular


Iliac crest

Durnin bicep measurement is

A vertical fold on the front of the arm over the biceps muscle, halfway between the shoulder and the elbow.

A vertical fold on the back of the upper arm, with the arm relaxed and held really at the side. Taken halfway between the shoulder right now though.

A vertical fold on the back of the upper arm, with the arm relaxed and held really at the side. Taken halfway between the shoulder right now though.

Durnin subscapular measurement is

A 45° angle fold of 1-2 cm, below the inferior angle of the scapula.

Durnin iliac crest measurement is

A 45° angle fold, taken just above the iliac crest & medial to the axillary line.

A person with a larger percentage of lean body mass will weigh

More in the water, ultimately having a lower body fat percentage.

Formula on how to calculate ones fat mass & lean body mass :

Body fat % X scale wt = fat mass


Scale wt - fat mass = lean mass

Calculate the fat mass in lean body mass of a 40-year-old woman weighing 130 lbs

Fat Mass :


.28 (bf%) X 130 (swt) =


36lbs of BF



Lean Body Mass :


130(swt) - 36(lbs of wt) =


94lbs of LBM

A circumference measurement is a measure of the

Girth of body segments (arm, thigh, waist, & hip)

Circumference methods are affected by both

Fat & muscle, therefore I do not provide accurate estimates of fatness.

Some of the uses & benefits of circumference measurements include :

Can be used on obese clients.


Good for comparisons/progressions.


Good for assessing fat pattern & distribution.


Inexpensive.


Little technician error.


Easy to record.


used for waist concert conference.


Used for waist to hip ratio (WHR).

Durnin bicep measurement is

A vertical fold on the front of the arm over the biceps muscle, halfway between the shoulder and the elbow.

A vertical fold on the back of the upper arm, with the arm relaxed and held really at the side. Taken halfway between the shoulder right now though.

A vertical fold on the back of the upper arm, with the arm relaxed and held really at the side. Taken halfway between the shoulder right now though.

Durnin subscapular measurement is

A 45° angle fold of 1-2 cm, below the inferior angle of the scapula.

Durnin iliac crest measurement is

A 45° angle fold, taken just above the iliac crest & medial to the axillary line.

In a SM uses the Durnin (Durnin-Womersley) formula To calculate a client’s

Percentage of body fat.

Durban formula’s 4 sites of skinfold measurements are as follows :

Biceps


Triceps


Subscapular


Iliac crest

Durnin bicep measurement is

A vertical fold on the front of the arm over the biceps muscle, halfway between the shoulder and the elbow.

A vertical fold on the back of the upper arm, with the arm relaxed and held really at the side. Taken halfway between the shoulder right now though.

A vertical fold on the back of the upper arm, with the arm relaxed and held really at the side. Taken halfway between the shoulder right now though.

Durnin subscapular measurement is

A 45° angle fold of 1-2 cm, below the inferior angle of the scapula.

Durnin iliac crest measurement is

A 45° angle fold, taken just above the iliac crest & medial to the axillary line.

Across the Adam’s apple.

Across the Adam’s apple.

Chest circumference measurement

Across the nipple line.

Waist circumference measurement

The narrowest point of the waist, below the rib cage & just above the top of the hip bones. If there is no apparent narrowing of the waste, measure at the naval.

Hips circumference measurement

Feet together, measure circumference at the widest portion of the buttocks.

Thigh circumference measurement

Measure 10 inches above the top of the patella for standardization.

Calf circumference measurement

The maximal circumference between the ankle and the knee, measure the calves.

Bicep circumference measurement

At the maximal circumference of the biceps, measure with arm extended, palm facing forward.

Risk for disease increases with a BMI of

25 or more.

Individuals who are underweight are also

At risk for premature death or illness.

Most to use clinical application of girth measurements.

Most to use clinical application of girth measurements.

The waist to hip ratio assessment is important becauseThe waist to hip ratio can be computed by dividing the

There is correlation between chronic diseases & fat stored in the midsection.

The waist to hip ratio can be computed by dividing the

Waist measurement by the hip measurement.

What are the 3 steps to compute the waist measurement?

1. Measure the smallest part of the clients waist, without instructing the clients draw in the stomach.


2. Measure the largest part of the clients hips.


3. Compute the waist to hip ratio by : waist/hip

If a clients waist measures 30in & hips Measure 40in what is the waist to hip ratio?

30/40=.75

Body mass index (BMI) is a roof assessment based on the concept that

A persons weight should be proportional to their height.

An elevated BMI is linked to

Increased risk of disease, especially if associated with a larger waist circumference.

What are the two ways to calculate BMI?

1.


BMI = Wt (kg)/Ht (m^2)


2.


BMI = [Wt (lbs)/Ht (in^2)] X 703

The lowest risk for disease lies within a BMI range of

22-24.9

Body mass index classification chart

Back (Definition)